肠道管理优化护理方案联合盆底功能锻炼在直肠癌保护性回肠造口回纳术后护理中的应用

Application of optimized nursing regimens for intestinal management combined with pelvic floor function exercise in the nursing after rectal cancer protective ileostomy

目的:探讨肠道管理优化护理方案联合盆底功能锻炼在直肠癌保护性回肠造口回纳术后护理中的应用价值。方法:选取2018年7月至2019年6月于复旦大学附属华山医院收治的60例行低位直肠癌根治术且1~3个月后行肠造口还纳术的直肠癌患者作为研究对象,采用奇偶数法将入组患者随机分为观察组和对照组,每组30例。对照组术后采用常规护理,观察组在对照组基础上采用肠道管理优化护理方案联合盆底功能锻炼,均干预9个月。比较两组患者干预后的日平均排便次数和夜间排便次数,干预前和干预3、6、9个月后的肛门wexner评分以及干预前、干预9个月后的大便失禁生活质量评分量表(FIQL)评分。结果:干预9个月后,观察组日平均排便次数和夜间排便次数、FIQL各方面评分、wexner评分均低于对照组,差异有统计学意义(P<0.05)。结论:肠道管理优化护理方案联合盆底功能锻炼在直肠癌保护性回肠造口回纳术后护理中的应用,可有效改善患者肛门失禁情况和排便功能,提升患者生活质量。

Objective To explore the application value of optimized nursing regimens for intestinal management combined with pelvic floor function exercise in the nursing after rectal cancer protective ileostomy.Methods A total of 60 patients with rectal cancer undergoing radical resection of low rectal cancer and then ileostomy after 1~3 months who were admitted to this hospital from July 2018 to June 2019 were enrolled as the research subjects.They were randomly divided into observation group and control group by even-odd method,30 cases in each group.The control group was given postoperative routine nursing,while observation group was given optimized nursing regimens for intestinal management combined with pelvic floor function exercise on basis of control group.All were intervened for 9 months.The times of daily average and night defecation after intervention,scores of anal wexner before intervention and after 3,6,9 months of intervention,and scores of fecal incontinence quality of life scale(FIQL)before intervention and after 9 months of intervention were compared between the two groups.Results After 9 months of intervention,times of daily average and night defecation in observation group were fewer than those in control group(P<0.05).FIQL scores in observation group were lower than those in control group(P<0.05).After 3,6 and 9 months of intervention,wexner scores in observation group were lower than those in control group(P<0.05).Conclusions The application of optimized nursing regimens for intestinal management combined with pelvic floor function exercise in the nursing after rectal cancer protective ileostomy can effectively improve anal incontinence and defecation function of patients,and improve their quality of life.